Functional endoscopic sinus surgery has been proven to be an effective treatment for patient with chronic rhinosinusitis with (CRSwNP) or without nasal polyps (CRSssNP). As well as polyps, a common intra-operative finding is pus in the sinuses. We present prospectively collected data on the outcomes for these patients as measured with the validated SNOT-22 score.
Data was prospectively collected of all patients who underwent endoscopic sinus surgery between October 2014 and October 2016. Pre- and post-operative data (at 6 weeks and 6 months) was collected in the form of the SNOT-22 questionnaire. A complete dataset was available for 197 patients. Wilcoxon paired Signed Ranks Test was used for nonparametric paired data and Mann-Whitney test for subgroup analysis.
197 patients were included in the final analysis: 74 female patients, 118 patients with nasal polyps and 57 patients with pus present intra-operatively. CRSwNP patients had lower scores than CRSssNP patients pre-operatively (p=0.037), at 6 weeks post-operatively (p=0.023) and at 6 months post-operatively (p=0.001). However, there was no difference in the median of change in scores at either time point. Pre-operatively patients who went on to have pus intra-operatively did not have different score from those without pus. However, at 6 weeks, these patients have significantly lower median scores (p=0.030). This difference however is not seen at 6 months post-operatively (p=0.802).
Our results show that presence/absence of polyps at the time of surgery does not correlate with a different outcome, but the presence of pus correlates with statistically significantly better early post-operative outcome.